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Quality, workforce and competition in home care


For a number of years social care policy has been geared towards providing more care in the community, particularly in people’s homes. While recent research has increased understanding of the care homes market in particular, relatively little is known about the market for domiciliary care. There is a lack of evidence on domiciliary care supply and the workforce that provides care. Further insight in these areas will develop the knowledge base to support policies aimed at improving provision of adult social care.


  • Conduct analyses of home care pay and staff turnover and the relationship between conditions of employment and quality of care.

  • Build on previous work analysing care homes markets to explore the dynamics of the domiciliary care market.

  • Build on previous work analysing the social care workforce to analyse labour supply in social care markets and explore its impact on the quality of care, with particular focus on domiciliary care. 


Analyses of Labour Force Survey data on pay rates and turnover of home care staff, and of a sample survey of home care agencies about their conditions of employment for their care staff, is being completed. Analysis of the association between agencies’ conditions of employment and the quality of their care as rated by the CQC is being carried out.

Available data on domiciliary care provision at local authority (LA) level will be used, particularly to assess the availability, competition as well as entry and exit of home care provision for the different types of social care service users.

The degree to which domiciliary care supply is affected by market competition and other relevant local market characteristics will be investigated using quantitative analysis. A longitudinal dataset of home care supply will be developed and populated with measures of potential drivers of supply.

Labour supply of social care workers will be investigated, and for domiciliary care workers in particular, where possible using appropriate datasets to examine regional differences in low skilled labour supply and estimate the impact of wages on hours of work using quantitative methods. 

The impact of staffing on the quality of domiciliary care provision will be estimated using NMDS-SC data matched with CQC quality ratings. A longitudinal model will assess whether indicators of staffing (e.g. wages, vacancies, turnover/retention) have a causal impact on quality.


Stephen Allan & Raphael Wittenberg (Leads), Florin Vadean, Katerina Gousia, Bo Hu, Amritpal Rehill


  • Start Date: January 2019

  • End date: June 2021

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